Urinary tract infections (UTI) may manifest as acute pyelonephritis and systemic illness with high fever, pain around the graft site, and laboratory data indicative of leukocytosis and active urinary sediment. Alternatively, renal allograft recipients with UTIs can be asymptomatic and present without pyuria. Because of this, a high index of suspicion is required, and routine surveillance urine cultures are often performed after transplantation. In febrile patients, blood cultures are obtained.
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